Has your child experienced an irregular heartbeat, leg swelling, shortness of breath or unexplained chest pain? If so, your child’s doctor may recommend that he have an echocardiogram test to help determine if heart problems cause his symptoms.

What Is an Echocardiogram Test?

Using high-frequency sound waves, echocardiograms (echo) provide a graphic outline of the heart’s movement. An echocardiogram test lets us evaluate the heart's structure, function and blood flow.

What Does a Heart Echocardiogram Show?

An echocardiogram is a painless test that uses sound waves to create pictures of the heart. The echocardiogram specialist can use this information to pinpoint various valves or heart chamber abnormalities and evaluate the heart’s ability to pump. Heart echocardiograms are frequently used to learn about many heart problems. Your echocardiogram specialist may have this test done to:

  • Check if the size of the heart is enlarged
  • See if heart valves do not open normally or do not form a complete seal when closed
  • Find blood clots or tumors in the heart
  • Look for heart muscles that are not pumping properly
  • Measure the thickness of heart walls
  • Evaluate the size and shape of the chambers in the heart
  • Locate defects in the heart’s structure
  • Identify fluid around the heart

Types of Heart Echocardiogram

An echocardiogram does not use radiation like X-rays and some other tests. There are four main types of echocardiograms. Depending on what your doctor needs to learn about your child’s heart, he will probably undergo one of the following types of echocardiograms:

The transthoracic echocardiogram is the most common type of test. This noninvasive echocardiogram involves spreading gel on the chest and passing a device over the skin called a transducer that aims an ultrasound beam at your child’s heart. Ultrasound waves bounce off structures in the heart and are transmitted to a computer, where they are converted to pictures on a video screen.

Out of the types of heart echocardiograms, a transesophageal echocardiogram (TEE) test may be used if your child’s doctor cannot get a clear picture of the heart with a transthoracic echocardiogram. During the TEE test, an ultrasound transducer is guided down the patient’s throat into the esophagus. The transesophageal echocardiogram test offers a close examination of the heart valves and chambers without interference from the ribs or lungs. Your child’s doctor should be able to get more detailed images of the heart from this location.

A Doppler echocardiogram test uses sound waves to bounce off blood cells moving through the heart and blood vessels. A Doppler echocardiogram procedure is used during most transthoracic and transesophageal echocardiograms to measure the speed and direction of blood flow in the heart.

A stress echocardiogram involves recording ultrasound images of the heart before and immediately after exercise to diagnose specific heart problems that occur only during physical activity. If your child cannot walk on a treadmill or ride a stationary bicycle, his doctor may give him medicine to make his heart work hard and beat fast.

A fetal echocardiogram is performed before a child is born to check if the fetus has heart defects.

A bubble echo, also called a bubble study, involves a traditional echo with an additional element – a small amount of salt called saline. The saltwater contains tiny bubbles, making it easier to photograph the heart and identify if there is a hole in the heart.

What Happens During an Echocardiogram?

The length of the procedure varies from person to person and can range from 15 minutes to an hour. A standard transthoracic echocardiogram does not require any special preparation. You will be asked not to give your child anything to eat or drink for several hours before a transesophageal or echo stress test. An echocardiogram usually takes less than an hour and can be performed in a hospital or doctor’s office. For more information about echocardiograms, visit the National Heart Lung and Blood Institute.

The procedure is done by trained echocardiogram specialists and can be done in a doctor’s office, an emergency room, an operating room, a hospital clinic or a hospital room.

  • Your child will be asked to lie on a table, and the echocardiogram specialist will attach metal discs (electrodes) to the chest and connect them to the echocardiogram machine.
  • Expect that the room will be dark to allow your echocardiogram specialist to see the video monitor better
  • The echocardiogram specialist will put gel on the skin to allow the sound waves to pass through
  • The probe will be passed across the chest and produce sound waves that bounce off the heart and “echo” back to the probe.
  • The sound waves will be transformed into pictures and will be displayed on the monitor.
  • The echocardiogram specialist may ask your child to hold his breath briefly to get better pictures.

Risks of an Echocardiogram

A heart echocardiogram is a standard and safe test. Although some may be uncomfortable, this procedure cannot harm or hurt you. It also doesn’t have side effects.

Pediatric Echocardiogram at Palm Beach Children’s Hospital

Please rest assured that your child is in great hands here at Palm Beach Children’s Hospital. Note that your child may be asked to lie still while the procedure is performed, so we recommend practicing beforehand. You will be able to be with your child throughout the procedure. Here are some tips to help you when the procedure day comes:

  • Your child doesn’t need to prepare unless the procedure will be carried out in sedation
  • The scan will happen in the chest area, so it will help if your child wears loose-fitting clothing
  • Please arrive a few minutes before your echocardiogram test appointment.

Palm Beach Children’s Hospital is committed to excellence in heart care for children, and it’s reflected in the recognition we’ve received from the American Heart Association for stroke and heart failure. You can’t go wrong with some of the most experienced and knowledgeable doctors and nurses in the medical field.

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